06-13-2017, 06:28 AM
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AAPC Community Wiki: HELP! CPT 90837 or 90847

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90837: In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or more.

Psychotherapy, also known as talk therapy, is a type of therapy in which the provider uses a series of techniques to treat the mental and emotional health problems of a patient. Psychotherapy includes the interactive process between the provider and the patient. The provider involves the patient in this therapeutic interaction with the aim to explore the thoughts, feelings, and behavior of the patient. The provider uses a variety of techniques based on communication, relationship building, and behavior change that target improvement of the mental health of the patient.
Use this code when the provider spends a minimum of 53 minutes up to 60 minutes face to face with the patient without an additional evaluation and management service.

90847: A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family.

The provider supplies psychotherapy to the patient and his family, when individual psychotherapy sessions are not sufficient. This is done to evaluate the treatment plan and role of family members in treatment. The provider delivers psychotherapy sessions, also known as talk therapy, to the patient and his family to assess the interpersonal relationships between the patient and his family members. The provider also performs these sessions to judge the approach of family members in coping with the conflicts and other issues related to the patient. The provider finally examines and adjusts the treatment plan, which may include medications or subsequent psychotherapy sessions and the responsibility of family members in the treatment process.

90837
Psychotherapy, 60 minutes with patient and/or family member
Lay description-
Psychotherapy is a variety of treatment techniques in which a physician or other qualified health care provider helps a patient with a mental illness or behavioral disturbance identify and alleviate any emotional disruptions, maladaptive behavioral patterns, and contributing/exacerbating factors. This treatment also involves encouraging personality growth and development through coping techniques and problem-solving skills. Report 90837 for 53 minutes or more of face-to-face time spent with the patient without an additional evaluation and management (E/M) service. Report 90838 if a separate E/M service is performed during the same encounter as the 53 minutes or more of psychotherapy.

The therapist provides family psychotherapy in a setting where the care provider meets with the patient's family jointly with the patient. The family is part of the patient evaluation and treatment process. Family dynamics as they relate to the patient's mental status and behavior are a main focus of the sessions. Attention is also given to the impact the patient's condition has on the family, with therapy aimed at improving the interaction between the patient and family members. Reviewing records, communicating with other providers, observing and interpreting patterns of behavior and communication between the patient and family members, and decision making regarding treatment, including medication management or any physical exam related to the medication, is included.

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